HIV: both the cause and the consequence of violence against women

In the UK the number of women living with HIV has been steadily growing since the beginning of the epidemic. Newly diagnosed women were only twenty percent of the new infections in 1996, but over forty percent in 2007. There are now more than 25,000 HIV positive women in the UK, but while government policy fails to address the link between HIV and violence against women, it is left to under-funded and under-staffed support groups to campaign for the human rights of women living with HIV.

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As a woman living with HIV, and as somebody who has worked for the past 10 years at Positively Women supporting countless women through the correlated traumas of an HIV diagnosis and domestic violence and abuse, I was elated to be invited to a Sophia Forum event that focused on the topic of Gender Violence and HIV. In spite of the overwhelming evidence worldwide of the connection between those two phenomena, the link is rarely discussed here in the UK.

Professor Charlotte Watts spoke of the way in which poverty, gender inequity and power inequality, make it impossible for women to challenge and overcome social and cultural norms that condone violence, as well as making it harder for women to access HIV services for prevention testing or treatment. Perpetrators of violence against women are much more likely to partake in high-risk behaviours - such as unsafe sex with multiple partners and alcohol or drug abuse - and therefore are more likely to be HIV infected. Furthermore, as forced sex is physically traumatic and is carried out without condoms, it is more likely to transmit the HIV virus. In reality, this means that in high prevalence countries, like South Africa, women with a violent partner are over 50% more likely to be HIV positive.

Women access more health services, and are often tested for HIV during pregnancy, so they are the ones who have to go back home and break the news to their partners. It is not uncommon for women to be accused of ‘bringing HIV into the home’ and this can exacerbate existing or initiate new abuse and violence. We know very well here at Positively Women that an HIV diagnosis can be the trigger that generates violence and can make escaping from it much more complex. In Tanzania research shows that women living with HIV are ten times more likely than HIV negative women to experience violence in the home; in the UK these figures are unknown. The fear that the partner may reveal their status to the wider community is often an insurmountable obstacle to escape domestic violence, as exemplified by this quote from one of our service users:

“I was taken to A&E for head injuries after he had punched me and I passed out. I could not tell anybody because he kept threatening to tell friends and family about my HIV status so I remained with him and the abuse”

Rahila Gupta, writer and management committee member of Southall Black Sisters, spoke about gender violence for the Black and Ethnic Minorities in the UK and how both British culture and legislation collude to ensure that violence against women continues. The two year law, for example , means that if an immigrant is married to a British citizen, legally she needs to wait for two years probation before she is given citizenship. This can effectively lock women into abusive relationships. If you put HIV in the mix, things become even more complex. Leaving an abusive marriage for an HIV positive migrant woman in the UK could lead to losing access to life-saving HIV medication. Southall Black Sisters have been campaigning to change this law since the 1990s.

Violence, immigration law and HIV create a bleak picture for many women in the UK. I recently visited an HIV positive woman in Holloway prison; I will call her Olu (not her real name). Olu came from a West African country and she was in her early 20s, she had been arrested for working with false papers. Olu’s tale was horrific. She had been smuggled in this country to be a domestic help. Her boss raped her repeatedly and also forced her to have sex with some of his friends. Olu managed to escape but didn’t have a passport, so she got some false papers to use to work as a cleaner. Olu was arrested while trying to open a bank account, once arrested she was diagnosed HIV positive in prison. I only saw her once. From prison she was moved to a detention centre and then deported back to her country where lack of medication and support means she will probably die. While the UK government promotes ‘Universal Access to HIV Treatment’, many HIV positive people are forcibly deported to countries where treatment is not available.

In the UK the number of women living with HIV has been steadily growing since the beginning of the epidemic. Newly diagnosed women were only 20% of the new infections in 1996, and over 40% in 2007. There are now more than 25,000 HIV positive women in the UK and not much is known about the correlated effect of HIV and violence on our lives.

Our actions and interventions as women living with HIV are severely limited by the fact that gender and gender violence are totally ignored by the nine-year-old HIV and Sexual Health Strategy . If HIV and gender are not prioritised in the most important piece of national policy around HIV, organisations like Positively Women and others, who offer support to women vulnerable or infected with HIV, will continue to struggle, under-funded and under-staffed. For us to develop a strong campaigning strategy within this context and network more efficiently with other women’s groups working on gender violence is extremely difficult.

Silvia Petretti is an HIV+ woman and activist based in London UK. She is Community Development Manager at Positively Women supporting HIV+ women around the UK developing self-help groups. Since 2004 Silvia has been coordinating Poz-Fem UK: The National Network of Women Living with HIV, which aims to skill up WLHIV to influence decisions that affect them.